My six year old son, diagnosed with type 1 diabetes about eight months ago, basically eats the same foods and drinks each day, yet his numbers seem to go all over the scale. This makes it hard to determine the proper amount of insulin to administer. Is this normal?

Answer:

The operant word is basically -- not exactly, same time, same amount, and same activity. Really, it is a fact that the food is different, the mix of carbs and protein and fat, etc., are all different. Activity plays a role. Insulin absorption, site of injection, etc., are all playing a role. Where you start the day has a role too. Many variables that make management of type 1 diabetes a chore.

[Editor's comment: At this length of time after diagnosis, it is possible that your son is still producing some of his own insulin. However, as beta cell function continues to degenerate, the insulin he is making may not always be enough or match the food absorption.

Another possibility may be the overuse of a sliding scale to correct the highs. Sometimes, depending on why the blood sugar was high in the first place, you can get rebound hyperglycemia and undetected lows. It might be helpful to keep constant dosages, making changes based on patterns, for a while and see what happens. I suggest that you discuss this with your son's diabetes team.
SS]

Last Updated: Tuesday April 06, 2010 15:09:38
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